Conventional Treatment Options for Inflammatory Bowel Diseases
Treatment options for Inflammatory Bowel Diseases include drugs, surgery, or a combination of both. The treatment of inflammatory bowel diseases depends on the location, severity, complications, and response to previous treatments.
The goals of these therapies are to control inflammation, correct nutritional deficits, relieve symptoms such as abdominal pain, diarrhea, and rectal bleeding. It is important to take into account the relationship of an early diagnosis for the effectiveness of less aggressive medicinal treatments. This will benefit the patient for a less stressful burden of side effects. Therefore, it is advisable to see an expert as soon as the first symptoms appear.
Table of Contents
- 1 Pharmacological options for the treatment of inflammatory bowel diseases
- 2 1. Anti-inflammatory drugs
- 3 2. Suppressors used in the treatment of inflammatory bowel diseases
- 3.1 Side Effects of Immune Suppressants
- 3.2 Other drugs used to treat inflammatory diseases
- 3.3 Surgical options for the treatment of inflammatory bowel diseases
- 3.4 Last words about the treatment of inflammatory diseases
- 3.5 Related Posts to Conventional Treatment Options for Inflammatory Bowel Diseases
Pharmacological options for the treatment of inflammatory bowel diseases
The following medications may be used to treat inflammatory bowel disease:
Aminosalicylates are medicines that contain 5 aminosalicylic acids (5-ASA) that help control local inflammations of the stomach. These medications are primarily used to treat inflammatory bowel diseases at mild and moderate levels, as well as for maintenance in the event of remission.
Side effects include:
- Threw up.
5-ASA agents, such as olsalazine, mesalamine, and balsalazide, have fewer side effects and can be used in people who can not take sulfasalazine. Balsalazide is converted into mesalamine within the colon, and has been shown to reduce inflammation in the bowel, diarrhea, rectal bleeding, and stomach pains. 5-ASA agents can be taken orally or rectally (through an enema or suppository), depending on the location of the inflammation. Sulfasalazine interferes with folate absorption, so people taking this medication should also take a folic acid supplement.
The use of aminosalicylate drugs or antibiotics may deplete vitamin K levels in patients with inflammatory bowel diseases, but the consumption of vitamin K supplements may alleviate the problem. Glucocorticoids or corticoids (such as prednisone and hydrocortisone) reduce inflammation. They are used to treat more severe cases of inflammatory bowel disease with the aim of stopping acute attacks.
Glucocorticoids can be taken orally, intravenously or rectally (with an enema or suppository), depending on the location of the inflammation.
Side Effects of Anti-Inflammatory Drugs
Glucocorticoids can cause serious side effects, including high risk of infection, diabetes, hypertension, bone loss, kidney problems, and ulcers. Other less serious effects include weight gain, acne, facial hair, and temperament changes. They are not recommended for long-term use, and are usually replaced with 5-ASA drugs once remission is achieved. The calcium and vitamin D can help fight bone loss caused by glucocorticoids.
2. Suppressors used in the treatment of inflammatory bowel diseases
This class of drugs acts by suppressing the immune system, hence its use is extremely delicate. Antimetabolites: Such as azathioprine and mercaptopurine prevent the replication of inflammatory T cell lines. They are used to treat people with IBD who have not responded to 5-ASA or glucocorticoids, or who are glucocorticoid-dependent. However, antimetabolites are slower acting than other types of drugs.
Cyclosporine: This drug inhibits T cells mediated by the immune response, thus reducing the immune reaction that underlies inflammation. It blocks a number of inflammatory cytokines, including TNF-α and various interleukins.
Methotrexate: The drug methotrexate, used in cancer chemotherapy, is used in patients with Crohn’s disease who are steroid dependent or who do not respond to glucocorticoids. It can be given orally or by weekly injections under the skin or muscles. Methotrexate is more effective in maintaining remission when given as an injection.
Biological products inhibiting TNF: During outbreaks, levels of the inflammatory cytokine TNF-α are elevated. This has led to an interest in antibodies such as infliximab, adalimumab, certolizumab pegol, and golimumab that block TNF-α. All of them have been shown to induce and maintain remission including mucosal healing and restoration of bowel barrier function. Immunosuppressive agents may also be considered: Tacrolimus, mycophenolate mofetil and thalidomide.
Side Effects of Immune Suppressants
Side effects depend on the medicine used in the treatment of inflammatory diseases. Anyone taking antimetabolites should be monitored to prevent complications such aspancreatitis, hepatotoxicity, decreased white blood cell count, and increased risk of infection.
A genetic test known as genotyped thiopurine methyltransferase (TMPT) may help predict who will suffer the serious adverse effects of antimetabolites. Because cyclosporin is associated with a significant risk of toxicity, its use is limited to severe cases of ulcerative colitis or Crohn’s disease. The methotrexate interferes with folate metabolism.
Folate should be supplemented, especially to help prevent colorectal cancer associated with that medication. Biological products that inhibit TNF are very expensive medicines, have not been shown to prevent colectomy in severe ulcerative colitis, and can cause autoimmune diseases, cancer, infections, and viral reactivation syndromes, such as shingles.
Other drugs used to treat inflammatory diseases
Sodium cromoglicate: This medication is a modification of the component called khella, and works as a stabilizer and anti-inflammatory of mast cells. A clinical study demonstrated that daily administration of 200 mg of sodium cromoglycate rectally for 15 days caused remission in almost all patients with ulcerative colitis. This was also maintained in 93% of cases when they took 240 mg daily for 2-3 years.
In another study, consumption of sodium cromoglycate at a dose of 1500 mg daily relieved diarrhea more effectively than with an elimination diet (in which problematic foods were avoided) in patients suffering from inflammatory bowel disease. This indicates that cromolyn can improve the reaction to certain foods. A factor that can cause inflammation in inflammatory bowel diseases.
As with non-patent medicines and therefore not very profitable, no government or company has seen the need to research more about this safe and inexpensive drug for inflammatory bowel diseases.
Naltrexone: Originally developed to help treat heroin addiction, low doses of naltrexone have demonstrated a number of notable immunological activities. A placebo-controlled study of the use of naltrexone at low doses (4.5 mg per day at bedtime) suggested that the drug could alleviate mucosal inflammation and induce clinical remission in patients with moderate to severe Crohn’s disease.
Naltrexone seems to alleviate inflammatory bowel disease, in part, by the decreased expression of proinflammatory cytokines and by contributing to tissue repair. At low doses, the medication may cause drowsiness, but other side effects are uncommon.
Surgical options for the treatment of inflammatory bowel diseases
In extremely severe cases of Crohn’s disease, abscesses may develop in chronically inflamed tissues. These abscesses can grow and create passages through tissue barriers to produce anal fistulas, or channels between organs. Nearly half of patients with perianal Crohn’s disease develop disease involving anal fissures, perianal abscesses, and fistulas.
These symptoms rarely respond well to conventional treatments. Surgery may be necessary in a high percentage of these patients. Complications are common. Surgery may also be recommended to remove severely inflamed portions of the intestinal tract, both in Crohn’s disease and in ulcerative colitis. The goal of surgery is to preserve as much of the bowel as possible, usually involves the colon or small intestine.
Occasionally, it will need to be brought to the surface of the skin to allow the removal of waste at the end of the intestine that has been left in place. When this procedure involves the small intestine, it is called ileostomy. If the procedure involves the colon, it is called a colostomy.
Last words about the treatment of inflammatory diseases
Although Crohn’s disease may reappear after surgery, the symptoms tend to be less severe and less debilitating than they were previously. Elemental diets (in which simple molecules such as glucose and individual amino acids replace whole foods) have been shown to reduce the recurrence of Crohn’s disease when used after surgery.
However, novel procedures have been developed to preserve fecal continence by using part of the ileum to create a pouch or reservoir connected to the rectal sphincter. In a comprehensive review, the use of probiotic supplements was able to significantly reduce the occurrence of pouchitis.
That is, inflammation of the deposit formed after the surgical creation of an ilio-anal pocket, by 96% compared to placebo after surgery in patients with ulcerative colitis.
You are the conventional options that exist in the treatment of intestinal diseases!